| NPI | 1700227840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: RI DO00849) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL UO3527) |
| Enumeration Date | 2013-07-16 |
| Last Update Date | 2022-07-21 |